Clinical Study Of Upper Sternal J Incision Minimally Invasive And Conventional Median Sternotomy Aortic Valve Replacement

ObjectiveThis study compares many Clinical variable（soperative time, cardiopulmonary bypasstime, aortic cross clamp time, mechanical ventilation time, postoperative ICU stay time,postoperative drainage volume, postoperative blood transfusion, incision length and so on）of the upper sternal J incision minimally invasive aortic valve replacement and thetraditional median sternotomy aortic valve replacement for the patients suffered fromaortic valve disease that aims to evaluate the upper sternal J incision minimally invasiveaortic valve replacement more objectively.MethodThis study was a retrospective comparison test, All aortic valve disease patients ofthis project were cured in Linyi people’s hospital. The clinical manifestation, physicalexamination, chest film, ECG and transthoracic echocardiography was used to confirm thediagnosis of aortic valve disease in these patients. All the patients were deemed to havesurgical indications for aortic valve replacement and to not have other coexisting cardiacanomalies, severe pulmonary hypertension, active infectious disease or diseases of otherorgans.All patients were divided into the upper sternal incision minimally invasive J AVRgroup and conventional median sternotomy AVR group according to their operation styles.20patients were selected respectively from the upper sternal incision minimally invasive JAVR group and conventional median sternotomy AVR group. The upper sternal J incisionminimally invasive AVR group was the experiment group, the conventional mediansternotomy AVR group was the control group. Record basic information（gender, age,body weight, left ventricular ejection fraction, aortic valve lesion types）of these40patientsrespectively, besides, record many clinical indicators such as the operation time, CPB time,aortic cross clamp time, mechanical ventilation time, postoperative ICU stay time, postoperative drainage, incision length, the number of postoperative transfusion, hospitalstay and cost of hospitalization. Statistical analyses were performed using the SPSSstatistical package version13.0. Quantitative data are reported as mean values±standarddeviation(SD). Baseline characteristics were compared using x2analysis and t-test. Theintergroup differences were analyzed with the t-test and intragroup comparison wasanalyzed by means of analysis of variance (ANOVA). Differences were consideredstatistically significant only with a P<0.05.ResultAll patients were treated successfully. There was no significant difference betweenthe two groups in terms of age, sex, weight or left ventricular ejection fraction (LVEF)（P>0.05）. And There was also no significant difference between the two groups in termsof the operation time, CPB time, aortic cross clamp time, mechanical ventilation time andhospitalization expenses（P>0.05）. Patients in the upper sternal J incision minimallyinvasive AVR group experienced significantly shorter postoperative ICU stay time,postoperative blood transfusion number, postoperative hospitalization time. They also hadsmaller surgical incisions and less drainage volume（P<0.05）.ConclusionIn conclusion, we found that the upper sternal incision minimally invasive J AVRgroup had better performance on the postoperative ICU stay time, postoperative drainagevolume, postoperative blood transfusion number, length of incision and the postoperativehospitalization time than the conventional median sternotomy AVR group. The uppersternal incision minimally invasive J AVR is a safe, less complex, feasible and effectivechoice for patients suffered from aortic valve disease.